Provider Demographics
NPI:1447093091
Name:STARKOFF, BROOKE (PHD, RDN, LDN)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:STARKOFF
Suffix:
Gender:X
Credentials:PHD, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 TRAIL EDGE CIR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7912
Mailing Address - Country:US
Mailing Address - Phone:216-408-2238
Mailing Address - Fax:
Practice Address - Street 1:107 TRAIL EDGE CIR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7912
Practice Address - Country:US
Practice Address - Phone:216-408-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09653133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered